Provider Demographics
NPI:1275574782
Name:SATTERFIELD, MISTY D (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MISTY
Middle Name:D
Last Name:SATTERFIELD
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:174 INDUSTRIAL PARK ROAD
Mailing Address - Street 2:
Mailing Address - City:JANE LEW
Mailing Address - State:WV
Mailing Address - Zip Code:26738-0000
Mailing Address - Country:US
Mailing Address - Phone:304-269-0613
Mailing Address - Fax:304-285-3738
Practice Address - Street 1:174 INDUSTRIAL PARK ROAD
Practice Address - Street 2:
Practice Address - City:JANE LEW
Practice Address - State:WV
Practice Address - Zip Code:26738-0000
Practice Address - Country:US
Practice Address - Phone:304-269-0613
Practice Address - Fax:304-285-3738
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV002499225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV2161074OtherUNITED HEALTHCARE
WV9335684OtherMEDICARE GROUP
WVDB1488OtherRAILROAD MEDICARE
WV001770698OtherMOUNTAIN STATE BCBS
WVDB1488OtherRAILROAD MEDICARE